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15 Cards in this Set
- Front
- Back
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RF for testicular torsion?
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violent movement or physical trauma
cryptorchid testis (undescended testis) atrophy of testis bell clapper congenital deformity (narrow attachment of spermatic cord on to testis/epididymis --> testist falls forward and is free to rotate within tunica vaginalis) |
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What are the clinical features of testicular torsion?
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acute onset of severe scortal pain, swelling +/- N/V
Absent cremasteric reflex no pain relief with testicle elevation (negative Prehn's sign) |
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What imaging can be done to diagnose testicular torsion?
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US with colour-flow Doppler probe over testicular artery (if torsion, no blood flow)
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Management of testicular torsion?
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emergency
manual or surgical detorsion + elective bilateral orchiopexy (fixation) |
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symptoms of torsion of testicular appendix
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similar to testicular torsion but may have small, tender, firm nodule (blue dot sign) representing the infarcted appendage in the anterosuperior pole of the testis
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How do you manage torsion of the testicular appendix?
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analgesia - most will subside over 5-7 days
surgical exploration and excision if diagnosis uncertain or refractory pain |
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What are the most common organisms involved in epididymitis?
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< 35 years - gonorrhea or chlamydia
> 35 years + homosexual males of any age - GI organisms (esp E Coli) |
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RF for epididymitis?
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UTI
Unprotected sexual contact instrumentation/catheter reflux |
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Clinical features of epidiymitis?
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sudden onset of scrotal pain and swelling +/- radiation along cord to flank
scrotal erythema and tenderness fever storage symptoms purulent discharge reactive hydrocele |
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What is Prehn's sign and what can it differentiate between?
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= pain relieved with elevation of testicles
+ve in epidydmitis but not in testicular torsion not a reliable sign though |
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Management of epididymitis?
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Anitbiotics
If likely to be from a UT source i.e. older men, prepubertal boys - trimethorprim, cephalexin If sexually acquired - ceftriazone or doxy + azithromycin Scortal support, ice, analgesia |
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How do you investigate a patient with suspected epidiymitis
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urinarlysis (pyuria), urine CS
+/- urethral discharge - gram stain |
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What complications can you get from epididymitis?
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testicular atrophy if severe
30% have persistent infertility problems |
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What side are most varicocele's on?
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90% of left side - left testicular vein is longer and joins the left renal vein
In an isolated right side varicocele beware of a right retroperiteonal mass |
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What is the difference between a communicating and a noncommunicating hydrocele?
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communicating hydrocele - patent processus vaginalis
non-communicating, processus vaginalis is not patient and does not hchange size during the day |
